| NPI | 1003166984 |
|---|---|
| Former Name | AMANDA PHOENIX |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 207RC0001X Internal Medicine, Clinical Cardiac Electrophysiology (Licence: IL 085.004469) |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2021-12-22 |